A Primary-Care Interventional Model on the Diverticular Disease: Searching for the Optimal Therapeutic Schedule.

Introduction: In routine colonoscopy, diverticulosis is the most commonly found feature, but only a minority of these cases show symptoms of diverticular disease.From June 2014 to December 2014, we enrolled prospectively 178 patients affected by symptomatic uncomplicated diverticular disease (Male/Female=0.47, mean age 71.

Diagnostic Accuracy of Obstructive Airway Adult Test for Diagnosis of Obstructive Sleep Apnea.

Rationale: The gold standard for the diagnosis of Obstructive Sleep Apnea (OSA) is polysomnography, whose access is however reduced by costs and limited availability, so that additional diagnostic tests are needed.

Objectives: To analyze the diagnostic accuracy of the Obstructive Airway Adult Test (OAAT) compared to polysomnography for the diagnosis of OSA in adult patients.

Methods: Ninety patients affected by OSA verified with polysomnography (AHI ≥ 5) and ten healthy patients, randomly selected, were included and all were interviewed by one blind examiner with OAAT questions.

Barbed reposition pharyngoplasty (BRP) for OSAHS: a feasibility, safety, efficacy and teachability pilot study. "We are on the giant's shoulders".

A new palatal procedure for snoring/obstructive sleep apnea (OSA) is described. The procedure was named as barbed reposition pharyngoplasty (BRP). The technique is described step by step.

European position paper on drug-induced sedation endoscopy (DISE).

Background: Although drug-induced sedation endoscopy (DISE) represents the most widespread diagnostic tool for upper airway endoscopic evaluation of snoring and obstructive sleep apnea hypopnea syndrome (OSAHS), many controversies exist about how to perform the sedation, the indications for DISE, and how to report DISE findings. The present position paper reports on a consensus as proposed by a group of European experts in the field of DISE after discussion during a recent dedicated meeting.

Methods: The authors have evaluated all the available evidence reported in the literature and have compared experience among various departments in leading European centers in order to provide a standardization of the DISE procedure and an in-depth insight in the main aspects of this technique.

Clinical outcomes and complications associated with TORS for OSAHS: a benchmark for evaluating an emerging surgical technology in a targeted application for benign disease.

Background: The aim of this study was to create benchmarks for evaluating clinical outcomes and complications of transoral robotic surgeries (TORS) in a multicenter setting.

Methods: 243 TORS for obstructive sleep apnea/hypopnea syndrome (OSAHS) operations, carried out between 2008 and 2012, were analyzed at 7 different centers. The average hospitalization was 3.

Comparing usability of NEXThaler(®) with other inhaled corticosteroid/long-acting β2-agonist fixed combination dry powder inhalers in asthma patients.

Background: Inhaler mishandling is a common issue among patients suffering from asthma and is associated with poor clinical outcomes and greater consumption of health-care resources. Ease of use can improve inhaler technique and, possibly, patients' preference for their inhaler device, which in turn may lead to better adherence to therapy.

Methods: This study investigated usability characteristics of NEXThaler(®) versus two other dry powder inhalers (DPIs; Diskus(®) and Turbuhaler(®)).

Combined transoral robotic tongue base surgery and palate surgery in obstructive sleep apnea-hypopnea syndrome: expansion sphincter pharyngoplasty versus uvulopalatopharyngoplasty.

Background: Transoral robotic surgery (TORS) for obstructive sleep apnea-hypopnea syndrome is a relatively young technique principally devised for managing apneas in the tongue base (TB) area and supraglottic larynx. This procedure is included in the so-called "multilevel surgery" often including a palatal and nasal surgery.

Methods: We carried out a retrospective analysis in order to understand in detail the relative impact on apneas of the 2 different procedures carried out in the palate area (expansion sphincter pharyngoplasty and uvulopalatopharyngoplasty).

The nose oropharynx hypopharynx and larynx (NOHL) classification: a new system of diagnostic standardized examination for OSAHS patients.

The main pathological event of obstructive sleep apnea hypopnea syndrome (OSAHS) is the apneic collapse of the upper airways (UA). Frequently, UA collapse occurs at the same time at different section levels. Identifying the site and the dynamic pattern of obstruction is mandatory in therapeutical decision-making, and in particular if a surgical therapy option is taken into account.

Drug-induced sleep endoscopy: conventional versus target controlled infusion techniques--a randomized controlled study.

Understanding the sites of pharyngeal collapse is mandatory for surgical treatment decision-making in obstructive sleep-apnea-hypopnea syndrome patients. Drug-induced sleep endoscopy (DISE) allows for the direct observation of the upper airway during sedative-induced sleep. In order to re-create snoring and apnea patterns related to a spontaneous sleep situation, the authors used a target-controlled infusion (TCI) sleep endoscopy (DISE-TCI), comparing this technique to conventional DISE, in which sedation was reached by a manual bolus injection.

Awake versus sleep endoscopy: personal experience in 250 OSAHS patients.

Identifying the site of obstruction and the pattern of airway change during sleep are the key points essential to guide surgical treatment decision making for Obstructive Sleep Apnoea-Hypopnoea Syndrome in adults. In this investigation, 250 cases were retrospectively analyzed in order to compare the pharyngolaryngeal endoscopic findings detected in the awake state, with those obtained in drug-induced sedation, by means of the Sleep Endoscopy technique. All endoscopic findings have been classified according to the semi-quantitative NOH staging.

Surgery vs ventilation in adult severe obstructive sleep apnea syndrome.

Background And Purpose: Management of severe obstructive sleep apnea-hypopnea syndrome (OSAHS) is challenging and needs multidisciplinary cooperation. Ventilation is considered the gold standard of treatment in severe OSAHS. The aim of the study was to compare the therapeutical efficacy of a type of surgery (maxillomandibular advancement [MMA]) vs a ventilatory treatment modality (autotitrating positive airway pressure [APAP]).

Hyoidthyroidpexia as a treatment in multilevel surgery for obstructive sleep apnea.

Conclusion: This type of surgery is effective in patients with obstructive sleep apnea syndrome (OSAS), but may not be effective in obese patients or those with a preoperative apnea hypopnea index (AHI)>35. For these reasons, the careful study and selection of patients is fundamental in the surgical treatment of OSAS.

Objectives: Evaluation of the efficacy of hyoid surgery combined with oropharynx and nose surgery in the treatment of OSAS.

The METIS project for generalist ultrasonography.

Reorganization of the community healthcare system and the growing presence of group practices in the field of general medicine have increased the demands placed on primary-care medicine, in terms of the skills required and the level of responsibility. Satisfying the need for rapid, effective primary-care solutions to the health problems of citizens is easier thanks to technological and medical advances that provide high level equipment at costs within the reach of general practitioners (GPs). In the near future, trained GPs equipped with appropriate diagnostic scanners will be able to handle up to 40% of the requests of ultrasound examinations of each primary-care group (each PCG includes approximately 15,000-20,000 citizens).

Sleep-related stridor due to dystonic vocal cord motion and neurogenic tachypnea/tachycardia in multiple system atrophy.

Sleep-disordered breathing and sleep-related motor phenomena are part of the clinical spectrum of multiple system atrophy (MSA). Stridor has been attributed to denervation of laryngeal muscles or instead to dystonic vocal cord motion. We studied 3 patients with nocturnal stridor in the setting of MSA.

Human immunodeficiency virus infection: personal experience in changes in head and neck manifestations due to recent antiretroviral therapies.

Both the incidence and prevalence of human immunodeficiency virus infection are increasing in the world. Diseases of ENT districts are more frequent in human immunodeficiency virus-infected patients and involve all the otolaryngological sites. The otorhinolaryngological manifestations in association with HIV infection are mainly atypical, so common in the clinical practice, really aspecific and very frequent in ENT daily routine (such as sinusitis, otitis, etc.

Role of skin-lined tracheotomy in obstructive sleep apnoea syndrome: personal experience.

Permanent tracheotomy was the first surgical procedure proposed for the treatment of severe obstructive sleep apnoea syndrome and is still the only surgical option that ensures, even in very severe cases, complete elimination of apnoea and, in turn, clinical remission. Improved knowledge of the causes of obstructive sleep apnoea syndromes and the increasing therapeutic options (instrumental, medical and surgical) have resulted in cases requiring tracheotomy as the only indispensable therapeutic option becoming more rare. At present, the only indications are in very occasional conditions of life-threatening obstructive sleep apnoea syndromes and in patients on whom continuous positive airway pressure is not tolerated or is not effective (severe deoxygenation or hypercapnia, severe respiratory disorder index, severe obstructive sleep apnoea syndrome-related arrhythmias, severe excessive daytime sleepiness, heart diseases or ischaemic encephalopathy exacerbated by obstructive sleep apnoea syndromes, obstructive pneumopathy exacerbated by obstructive sleep apnoea syndromes, severe obstructive sleep apnoea syndromes with few chances of resolution with other surgical procedures or failure of the latter).

Temporary tracheotomy in the surgical treatment of obstructive sleep apnea syndrome: personal experience.

Aim of the study is a retrospective analysis on the use of temporary tracheotomy in our snoring surgery experience. From September 1996 to April 2002, 1103 snoring surgery procedures have been carried out on various sites of the upper airways in 530 patients (mean age 50 years, 81% males) prevalently related to severe Obstructive Sleep Apnea Syndromes (33%). Of these patients, 472 (89%) were operated upon under general anaesthesia, whereas 58 (11%) received local anaesthesia.

[Semont maneuver vs. particle repositioning maneuver: comparative study].

In the present study 80 consecutive cases of PPV of the posterior semicircular canal are presented, with the purpose to evaluate the effectiveness of the treatment and to analyze the secondary Ny and re-test as indicators of the effectiveness of the therapeutic maneuver. The patients were treated in 40 cases with Particle Repositioning Maneuver (PRM) and in the other 40 with the Semont Maneuver, in an attempt to determine the secondary Nystagmus induced during treatment and any residual Paroxysmal Positional Nystagmus (PPNy) upon repetition of the Hallpike positioning after 15 minutes (re-test). Recovery was achieved in 80% of cases after the first session and in 95% of cases with the third session.

Long-term effects of a nationwide control program on the seropositivity for Trypanosoma cruzi infection in young men from Argentina.

Unselected nationwide cohorts of Argentine men 18 years of age summoned for military service were tested for antibodies to Trypanosoma cruzi each year from 1981 to 1993. After an initial screening using indirect hemagglutination test, the positive sera were retested by titrated indirect hemagglutination and immunofluorescence antibody tests at 39 laboratories or at the national reference center in Buenos Aires. Nearly 1.

[Effectiveness indices in "Particle Repositioning Maneuver" by Parnes and Price-Jones].

The Parnes and Price-Jones "Particle Repositioning Maneuver" (PRM) was used to treat Paroxysmal Positional Vertigo (VPP) in 36 consecutive cases, studying both any induced secondary nystagmus and any persistent Paroxysmal Positional Nystagmus (PPNy) upon repetition of the Hallpike positioning after 15 minutes (re-test). The purpose of the study was to evaluate the ability to use secondary Ny and the retest to predict maneuver effectiveness. Although the PRM was quite effective (PPNy disappeared in 86% of the cases after a single session), the low observation frequency reduced the feasibility of using secondary Ny.

[Clinical features and diagnosis of mucocutaneous leishmaniasis in patients of an endemic area in Salta].

A total of 39 patients with a clinical diagnosis of mucocutaneous leishmaniasis, in an endemic area for leishmaniasis in Salta, Argentina, were examined between June 1990 and December 1992. Of these cases, 87% (34/39) presented the cutaneous simple form, 10.3% the cutaneous multiple form and 2.

Diagnostic role of videothoracoscopy in mediastinal diseases.

Objective: In order to assess the role of videothoracoscopy in the diagnosis of mediastinal diseases, we report a retrospective analysis of 52 cases of mediastinal biopsy performed with this technique.

Methods: Between January 1992 and December 1996 52 patients (39 men and 13 women, mean age 53 +/- 29 years) with mediastinal lesions were referred to our department for videothoracoscopic biopsy. There were eight lesions in the anterior mediastinum, while the remaining 44 were in the middle (25 right and 19 left).

Leishmania (Viannia) braziliensis: biological behavior in golden hamsters of isolates from Argentine patients.

This study reports intraspecific variations of native isolates of Leishmania (Viannia) braziliensis from patients with leishmaniasis from Salta, Argentina. These isolates induced skin lesions in golden hamsters, initially showing rapid development, reaching their largest size between 28 and 35 days postinfection (PI). Thereafter, the infections were self-limiting and total regression was observed at 80-150 days PI.